Human vaccines & immunotherapeutics
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Despite being recognized as one of the most successful public health measures, vaccination is perceived as unsafe and unnecessary by a growing number of individuals. Lack of confidence in vaccines is now considered a threat to the success of vaccination programs. ⋯ First, we will characterize vaccine hesitancy and suggest the possible causes of the apparent increase in vaccine hesitancy in the developed world. Then we will look at determinants of individual decision-making about vaccination.
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Studies to better understand the determinants of vaccine acceptance have expanded to include more investigation into dynamics of individual decision-making as well as the influences of peers and social networks. Vaccine acceptance is determined by a range of factors, from structural issues of supply, costs and access to services, as well as the more demand-side determinants. The term vaccine hesitancy is increasingly used in the investigation of demand-side determinants, moving away from the more polarized framing of pro- and anti-vaccine groups to recognizing the importance of understanding and engaging those who are delaying vaccination, accepting only some vaccines, or who are yet undecided, but reluctant. ⋯ This article suggests modes of investigating the determinants of vaccine confidence and levers of vaccine acceptance toward better engagement and dialogue early in the process of decision-making. Pressure to vaccinate can be counter-productive. Listening and dialog can support individual decision-making and more effectively inform the public health community of the issues and concerns influencing vaccine hesitancy.